2017 Epidemiological Report Delaware State Epidemiological Outcomes Workgroup Strategic Prevention Framework- Partners for Success

Changes in the Epidemiological Report This year the 2017 Epi. Report incorporated feed from our SEOW Members Major changes include: Introductory Narratives Local and National context New Sections That addresses specific issues Website now includes subsection for easier navigation Data in Action How to apply data to inform policy and practice Changes in the Epidemiological Report

Narrative This year there are 11 subsections; 9 of which have their own narrative The narratives provide the user: Local and national contexts of the topic Policy implications Health Impacts Narrative

New Sections Opioids Mental Health Adverse Childhood Experiences This section focuses on the use and abuse of opioids both locally and nationally Prescription Monitoring Program Mental Health Explores mental health issues in Delaware Adverse Childhood Experiences How these experience effect both mental health and substance use Protective Factors What steps parents and communities can take to protect adolescents from poor mental health and substance use New Sections

Subsections for Easier Navigation Breaks down the epi report into individual chapters Each chapter focuses on a different topic Allows users to hone in on data pertinent to their mission Available online at: https://www.cdhs.udel.edu/seow/reports-and-products Subsections for Easier Navigation

Using Delaware data to inform policy and practice Data In Action Using Delaware data to inform policy and practice

One of the prevention interventions supported by the Strategic Prevention Framework are environmental strategies. Changes in policy or practice are environmental strategies. Policy as Prevention

KEEP UP THE GOOD work! Reduce youth tobacco use Source: 2016 Delaware School Survey KEEP UP THE GOOD work! Reduce youth tobacco use

Target youth use when considering interventions Targeting youth about tobacco should continue to be a focus of prevention work. Avg. age of onset is 14.3 for 11th graders, 12.5 for 8th 88% of smokers report smoking before age 18; 99% before age 26 (CDC) Raise the cost of cigarettes: Raising the cost estimated to reduce smoking between 3-5% People under the age of 26 between 2-3 times more likely to be deterred from smoking due to higher prices of cigarettes (CDC). Raise the purchase age to 21: Delaware law preempts attempts by municipalities to raise the purchase age. Target youth use when considering interventions

Educate youth on the risks of e-cigarettes Source: 2016 Delaware School Survey Nationwide, there was a 900% increase in youth use of e-cigarettes between 2011- 2015 (Surgeon’s General Office, 2016). Data from the Youth Tobacco Survey in Delaware also shows an increase in youth use of e-cigarettes. Less than 15% of eleventh graders and eighth graders reported “great risk” in the use of e-cigarettes/vaping devices Educate youth on the risks of e-cigarettes

Source: 2016 Delaware School Survey Alcohol use

Social host laws hold adults accountable for underage drinking that occurs on their property, even if they did not provide the alcohol to the youth. Of youth who reported past month drinking: Nearly 1/3 of 11th graders and 1/5 of eighth graders, attended a party where parents bought alcohol within the past year (DSS). Evaluations of the implementation of social host laws have found evidence for: A reduction in drinking and driving Decrease in number of large gatherings where underage drinking occurs (University of Wisconsin, Population Health Institute, n.d.). Social Host Laws Show evidence of Reduction in underage Drinking and Driving

Marijuana: Changing Perceptions of Risk Source: 2016 Delaware School Survey Marijuana: Changing Perceptions of Risk

Source: 2016 Delaware School Survey

Changing Perceptions of risk may lead to increased use The amount of THC in marijuana seized by the DEA has increased nearly 200 percent since 1995, with average levels of THC around 12% (ElSohly et al., 2016). Marijuana concentrates, can have levels of up to 75% THC (ElSohly et al., 2016; the Academies 2017). Numerous studies on brain development and marijuana use show differences in cognitive functioning between heavy users and abstainers (see: Lisdahl et al., 2013 and Gruber et al., 2017 for two reviews of the literature). It is important that we continue to keep youth informed of these risks, especially since brain development continues until the mid-20s. Changing Perceptions of risk may lead to increased use

Primary Drug at Admission 2005 Total 2005 Percent 2015 Total 2015 Percent Alcohol 2336 28% 1093 11% Heroin 2234 26% 3723 38% Cocaine 533 6% 107 1% Crack/Cocaine 943 143 Marijuana/Hashish 1801 21% 873 9% Amphetamine 18 0% 30 Other Opioids & Synthetics 286 3% 643 7% Other/Missing/Unknown/None 329 4% 3265 33% State Total 8480 100.0% 9877 100% Source: Office of Controlled Substances, Division of Professional Regulation DE. Opioids: Increase access to treatment services

Promising signs & Room for Improvement Delaware is currently in need of expanded treatment options Two recent bills signed into law (SB 41 and HB 100) were created to address ongoing insurance disputes about inpatient treatment. Despite progress and ongoing efforts to address this, the needs exceed existing treatment resources. Promising signs & Room for Improvement

Nationally, up to 70% of women who enter treatment do have children (DHHS, 2016). Treatment programs that accommodate mothers with children have higher success rates with women with children, than those that do not (DHHS, 2016). Expanding treatment options that are responsive to the needs of caregivers may help improve treatment outcomes across the state. One promising program in the state is out of Connections, CSP which provides in-patient treatment for pregnant women who have been convicted of a crime, and would have otherwise been incarcerated. Women in treatment

Prevention starts at home Depressed for two weeks at a time Males Females 21 12 30 36 23 47 41 31 Self-Harm 11 5 16 17 22 13 Attempt Suicide 3 7 9 Prevention starts at home Source: 2015 High School Youth Risk Behavior Survey

Parents matter! Source: 2015 High School Youth Risk Behavior Survey

The SEOW is currently working on providing interactive data maps Using data gathered at the Center and through ArcGIS Online, we are able to provide easy to use data tools: http://udel.maps.arcgis.com/apps/webappviewer/index.html?id=3 b97b0f288434e649da409c74fed5600 Interactive Data Maps

Thank you!